Benvenuti Chiara, Gaudio Mariangela, Jacobs Flavia, Saltalamacchia Giuseppe, De Sanctis Rita, Torrisi Rosalba, Santoro Armando, Zambelli Alberto
IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy.
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy.
Biomedicines. 2023 Apr 3;11(4):1083. doi: 10.3390/biomedicines11041083.
Visceral crisis is a life-threatening clinical condition requiring urgent treatment and accounts for 10-15% of new advanced breast cancer diagnoses, mainly hormone receptor-positive/human epidermal growth factor 2 negative. As its clinical definition is an open topic with nebulous criteria and much room for subjective interpretation, it poses a challenge for daily clinical practice. International guidelines recommend combined chemotherapy as first-line treatment for patients with visceral crisis, but with modest results and a very poor prognosis. Visceral crisis has always been a common exclusion criterion in breast cancer trials, and the available evidence mainly comes from limited retrospective studies which are not sufficient to draw solid conclusions. The outstanding efficacy of innovative drugs, such as CDK4/6 inhibitors, questions the role of chemotherapy in this setting. In the lack of clinical reviews, we aim to critically discuss the management of visceral crisis, advocating future treatment perspectives for this challenging condition.
内脏危象是一种危及生命的临床状况，需要紧急治疗，在新诊断的晚期乳腺癌中占10% - 15%，主要为激素受体阳性/人表皮生长因子2阴性。由于其临床定义是一个开放的话题，标准模糊且有很大的主观解释空间，这给日常临床实践带来了挑战。国际指南推荐联合化疗作为内脏危象患者的一线治疗方法，但效果一般且预后很差。内脏危象一直是乳腺癌试验中常见的排除标准，现有证据主要来自有限的回顾性研究，不足以得出确凿结论。CDK4/6抑制剂等创新药物的显著疗效，对化疗在这种情况下的作用提出了质疑。在缺乏临床综述的情况下，我们旨在批判性地讨论内脏危象的管理，倡导针对这种具有挑战性状况的未来治疗前景。
